Remote healthcare has boomed since the COVID-19 pandemic, delivering clear benefits – but also highlights the need for better data.

The use of telemedicine – delivering healthcare at a distance, be it online or a phone call – has boomed since the global COVID-19 lockdowns. 

A new report describes the growth of telemedicine since the pandemic, and its impact on healthcare systems.    

The report, commissioned by the Health Committee of the Organisation for Economic Co-operation and Development (OECD) and published today, aims to assess the impact of the COVID-19 pandemic on the use of telemedicine in OECD countries. 

When COVID-19 hit, and many people were required to stay home, healthcare providers quickly expanded telemedicine.  

As telemedicine has boomed, it is crucial to understand the use and impact of telemedicine as a tool for the delivery of patient care. Niki O’Brien Policy Fellow in Global Health at IGHI

A team of researchers at Imperial College London’s Institute of Global Health Innovation (IGHI) captured high quality evidence in a literature review of the use of telemedicine in OECD countries for the report. They found that peer-reviewed articles on telemedicine were scarce prior to the COVID-19 pandemic.  

Niki O’Brien, Policy Fellow in Global Health at IGHI and contributor to the report, said: “As telemedicine has boomed, it is crucial to understand the use and impact of telemedicine as a tool for the delivery of patient care. This mode of health care delivery will continue to expand and evolve in OECD countries and beyond, so it is critical that services are developed with quality, safety and equity in mind.” 

Patient outcomes 

The sudden increase in online provision allowed access and continuity of care during lockdowns, but evaluating its impact remains a challenge due to a lack of data on use, costs, and impact. 
 
For many, the expansion of telemedicine was good news. Across the OECD, patients who used telemedicine services are overwhelmingly satisfied. Around two in five patients who used remote care services during the pandemic even prefer telemedicine services to in-person appointments. While some patients prefer remote services, it is unclear whether services are equally accessible across populations, and more research is needed on whether they are good value for health systems. 
 

Many patients now expect remote care to be just another way to access the health system Tiago Cravo Oliveira Hashiguchi Lead author, OECD report

Tiago Cravo Oliveira Hashiguchi, lead author of the OECD report, said: "Many patients now expect remote care to be just another way to access the health system, but for health care providers and policy makers, questions remain regarding how to regulate the use of telemedicine, how to pay for it, and how to make sure that it constitutes good value for money."   

Telemedicine has great potential and many applications deliver good positive outcomes for patients and health systems. For example, one study of mental health telemedicine showed 81% of clinical staff considered the quality of telemedicine consultations to be either good or excellent. Another, looking at surgical oncology wards in the Netherlands, found that remote patient monitoring may have potential to improve patient safety by generating early warnings for deterioration to nursing staff. 

However, the report also showed that there is limited data collection on quality indicators in several OECD countries. The new report also raised concerns about the duplication of care across remote and face-to-face services that may have implications for health system costs, another area which requires additional data and further study. 

Reggie Williams, Vice President, International Health Policy and Practice Innovations, Commonwealth Fund said: “Across OECD countries, we see potential for telemedicine to play an important role in increasing access to healthcare services, especially primary care and mental health services. Analyzing cross-country differences can provide insights on the ways health systems and policymakers can continue to support blended, virtual or in-person approaches to increasing overall access and reach people in need of care.” 

There is potential to use the COVID-19 boom in telemedicine to increase research on this topic and support improved remote healthcare around the world.

The future of telemedicine 

There’s evidence that remote care can deliver safe and high quality healthcare for patients, and savings for providers – but more research is needed.  

The OECD report highlights priorities for policy makers: 
 

1. Learn more about which patients are using remote care services, why they are using these services and what happens after they use them.  
2. Investigate whether payment and organisational arrangements for provision of telemedicine services, are creating economic incentives that encourage appropriate and effective use of services. 
3. Foster a model of integrated care delivery in which remote and in-person care services are fully co-ordinated and part of a seamless care pathway. 

Dr Saira Ghafur, Digital Health Lead at IGHI said: “We’re excited about the potential of telemedicine to build on important progress made through the COVID-19 pandemic, and with further research into quality and safety, as well as reimbursement and pricing models, we can improve services and accessibility for all patients.” 

The report, ‘The future of telemedicine and the COVID-19 pandemic’ was commissioned by the Health Committee of the Organisation for Economic Co-operation and Development (OECD), and published on 17 January 2023.